单操作孔与三孔胸腔镜肺癌根治术治疗非小细胞肺癌的效果及对肺功能的影响

Influence of single hole and porous thoracoscopic lung cancer radical operation on the operation effect and lung function of NSCLC patients

目的探讨两种胸腔镜肺癌根治手术对非小细胞肺癌(NSCLC)患者的手术及患者肺功能的影响。方法回顾性分析2016年4月至2019年8月绍兴市人民医院实施单操作孔胸腔镜手术治疗的60例NSCLC患者作为研究组,另选同期采用传统三孔胸腔镜手术治疗的60例NSCLC患者作为对照组,对比两组的手术过程、术后并发症、术后血细胞因子浓度及肺功能等相关指标。结果研究组手术时间长于对照组(P<0.05),研究组术中出血量、切口总长度、术后引流量均显著低于对照组(P<0.05),研究组清扫淋巴结数目、中转开胸、住院时间和对照组差异无统计学意义(P>0.05);研究组的术后12 h、24 h、48 h和72 h的疼痛程度评分均显著低于对照组(P<0.05);术后24 h、72 h,研究组的血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、血管内皮细胞生长因子(VEGF)水平显著低于对照组(P<0.05);术前,两组患者的肺活量占预计值的百分比(VC%)、第一秒用力肺活量占预计值的百分比(FEV1%)、最大通气量占预计值的百分比(MVV%)差异无统计学意义(P>0.05);术后2个月,研究组的VC%、FEV1%、MVV%值显著高于对照组(P<0.05);研究组的手术并发症率8.33%与对照组的15.00%比较,差异无统计学意义(P>0.05)。结论单操作孔胸腔镜手术实施肺癌根治术的手术时间增加,可有效减少手术出血量、术后肺功能恢复更快。

Objective To explore the effect of two kinds of thoracoscopic lung cancer radical operation on non small cell lung cancer(NSCLC)patients.Methods 60 NSCLC patients treated with single hole thoracoscopy were in the study group and 60 NSCLC patients treated with traditional three hole thoracoscopyin our hospital were in the control group.The collection time was from April 2016 to August 2019.The operation process,postoperative complications,blood cytokine concentration and lung function of the two groups were compared.Results The operation time was longer in study group than that in control group(P<0.05).The hemorrhage volume,total length of incision and drainage after the operation in study group were significantly lower than those in control group(P<0.05).There were no statistically significant difference between the number of lymph node dissection,thoracotomy,hospitalization time between two groups(P>0.05).The postoperative pain scores of 12h,24h,48h and 72h after surgery in study control were significantly lower than those in control group(P<0.05).The levels of serum IL-6,TNF-A and VEGF on postoperative 24h and 72h in the study group was significantly lower than those of the control group(P<0.05).Before operation,there were no statistically significant difference of VC%,FEV1%and MVV%in the two groups(P>0.05).2 months after operation,the values of VC%,FEV1%and MVV%were significantly higher in study group than those in control group(P<0.05).The rates of complications were 8.33%in study group and 15%in control group,and the difference was not statistically significant(P>0.05).Conclusion The operation time of radical thoracoscopic surgery is increased with single hole thoracoscopy in NSCLC patients,but it can reduce the amount of bleeding with the recovery of lung function faster after operation.